多発性胃潰瘍の臨床病理学的検討

A Clinico-pathological Study of Multiple Gastric Ulcers

　胃における消化性潰瘍の好発部位は，大井ら¹⁾によって明らかにされたごとく，胃底腺と幽門腺の境界領域，あるいはそれよりやや幽門側とされている．このことは単発性潰瘍の場合は容易に容認できるが，多発性潰瘍では多少の問題点を内蔵している．すなわち多発性潰瘍の中でも接吻潰瘍，あるいは線状潰瘍は境界領域に沿って発生するので，潰瘍好発部位の原則と一致し問題はないが，小彎線に平行にたて，あるいはややななめに発生する多発性潰瘍は潰瘍の好発部位の原則とどのような関係にあるか興味ある問題である．従来の研究ではこのような点について詳細に検討した業績は意外に少ないので，本論文の主題としてとりあげた．

　Among the cases of mutiple gastric ulcers, those that had ulcerations arranged in parallel or obliquely to the axis of the lesser curvature were subjected to this study, with the exclusion of multiple gastroduodenal ulcers. Twenty-six cases were divided into the following groups.

　Group 1: Multiple ulcers located in the intermediate zone and pyloric gland area. This group consists of 15 cases.

　Group 2: Multiple ulcers located in the intermediate zone. This group consists of 9 cases.

　Group 3: Multiple ulcers localized in the pyloric gland area. This group comprises 2 cases.

　In the group 1, ulcers located in the pyloric gland were shallower and showed higher tendency to heal than those in the intermediate zone. The same correlation was recognized between the groups 2 and 3.

　Analysis of the stomach juice showed higher acidity in the group 1 than in the group 2. Multiple ulcers located over different areas showed different phases in the course of healing, while those localized in the intermediate zone showed the same phase of healing.